Non-autistic adults rated autistic children’s empathy lower, especially those with a medical-model view of autism

A study published today in the Journal of Autism and Developmental Disorders looked at how non-autistic adults judge empathy in autistic and non-autistic children. The adults gave lower ratings to autistic children’s answers. The gap was widest among adults whose deeper understanding of autism was grounded in the medical model, which the authors describe as a deficit-based view of autism.

The paper is by Wing-Chee So and Xiao-Han Li of the Chinese University of Hong Kong.

The idea behind the study

The researchers start from the double empathy problem. Milton first set out this theory in 2012. It says that empathy works in both directions, and that difficulties between autistic and non-autistic people come from different experiences and expectations, not from autistic people lacking empathy. The authors set this against the older deficit-based view.

What the researchers did

According to the abstract, 82 autistic and non-autistic children answered questions about different emotional situations. The questions covered three things:

• cognitive empathy: understanding what someone else feels
• affective empathy: sharing or responding to that feeling
• proposed responses: suggesting a kind or helpful thing to do

What the children said was written up as 301 transcripts. Then 61 non-autistic adults read the transcripts and scored each one from 1 to 5 on those three areas. The researchers also looked at the adults’ understanding of autism, their own autistic traits, and how much contact they had had with autistic people.

What they found

Overall, the adults scored autistic children’s answers lower than non-autistic children’s. Adults with a deeper understanding of autism grounded in the medical paradigm showed a bigger difference between their ratings of the two groups.

The authors conclude that autistic children may express empathy differently, and that non-autistic people may misread these responses, especially people who hold a deficit-based medical view.

Why it matters

Judgements about empathy can affect how autistic children are seen by the adults around them. The finding fits the double empathy idea: the “problem” may sit partly with the person doing the judging. It also suggests that knowing more about autism may not help if that knowledge frames autism as a deficit.

Limitations

The abstract leaves some important things unclear:

• Only non-autistic raters. No autistic adults rated the answers, so we can’t tell whether they would have judged them differently. That comparison is central to the double empathy idea.
• Transcripts only. The adults read written words. They didn’t hear tone of voice or see facial expressions or what the children did. Empathy in real life involves much more than a spoken answer to set questions.
• A ratings study, not proof of cause. The link between medical-model understanding and wider rating gaps is an association. It doesn’t show that those beliefs caused the difference.
• Missing details. The abstract doesn’t give the children’s ages, how many were autistic, where the children were recruited, or how “understanding of autism” was measured. It also doesn’t say whether autistic people were involved in designing the research.
• Small sample. 61 raters is a modest number, so the results need repeating with larger and more varied groups.

The study doesn’t show that autistic children lack empathy. Its authors argue that autistic children’s empathy may look different, and that non-autistic people may miss it.

This piece summarises the paper’s abstract. Read the paper for the full methods and findings.